What the Pediatric Respiratory Rate, Pulse Rate, and Blood Pressure Means

The pediatric vital signs (respiratory rate, pulse rate, and blood pressure) give critical information about the condition of child having trouble breathing or having unusual drowsiness, irritability, confusion, or coma.

The following tables are from the 2006 edition of Pediatric Advanced Life  Support.

  Normal Respiratory Rates by Age

Age                                   Breaths per Minute

Infant (less than one year)                     30 to 60

Toddler (1 to 3 years)                             24 to 40

Preschooler (4 to 5 years)                      22 to 34

School Age (6 to 12 years)                     18 to 30

Adolescent (13 to 18 years)                   12 to 16

If a child of any age is breathing faster than 60 breaths per minute, this is abnormal and needs to be evaluated urgently. A breathing rate of below normal also  needs to be evaluated urgently and  may mean impending respiratory arrest. The treatment for impending respiratory arrest is to help the infant or child breath intially with bag-mask ventilation.

Normal Heart Rates (Pulses) per minute by age

Age                                        Awake Rate           Mean        Sleeping rate

Newborn to 3 months          85 t0 205            140             80 to 160

3 months to 2 years             100 to 190          130             75 to 160

2 years to 10 years              60 to 140             80              60 to 90

greater than 10 years         60 to 100             80              50 to 90

To find the heart rate check the pulse, listen to the heart with a stethoscope, or view the heart rate on a monitor.

A faster than normal heart rate is called a tachycardia and a slower than normal heart rate is called a bradycardia. Fever, pain, and anxiety can cause a rapid heart rate (tachycardia) as can respiratory distress, respiratory failure, shock, and abnormal heart rythms. The most important cause of a slow heart rate is abnormally low oxygen in the blood. A slow heart rate in an infant or child struggling to breath requires immediate help to breath (usually with bag-mask ventilatory support).

Abnormally Low Blood Pressure (Hypotension) by age

Age                                                        Systolic Blood Pressure (mm Hg)

Term Neonate  (0 to 28 days)                          Less than 60

Infants (1 to 12 moths)                                      Less than  70

Children (1 to 10 years)                                    Less than 70 plus 2 times the age in  years

Children ( greater than 10 years)                    Less than 90

The blood pressure consists of two numbers: an upper or higher number called the systolic blood pressure and a lower number or bottom number called the diastolic blood pressure. In a seriously ill child we direct our therapy at the low systolic number. Low systolic blood pressure in a child  means decompensated shock (inadequate blood flow to meet the needs the body). A child in decompensated shock needs vigorous intravenous fluid administration and airway and breathing treatment to prevent cardiac arrest.

This entry was posted in Emergency Medicine, Neonatal Resuscitation, Pediatric Advanced Life Support, Pediatric Vital Signs, Pediatrics and tagged . Bookmark the permalink.